Refugee Health in Minnesota

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1 Refugee Health in Minnesota Refugee and International Health Program LPH VOLAG Forum January 29, 2015

2 Populations We Serve Center for Health Equity / Office of Minority and Multicultural Health o Populations of color and American Indians International Health Program o Refugees, immigrants, LEP persons Refugee Health Program o Recently arrived refugees

3 Infectious Disease Epidemiology, Prevention and Control

4 Refugee and International Health Program Staff International Health Coordinator LEP Communications Planner International Health Planner Student Workers (x3) Refugee Health Coordinator Refugee Health Nurse Consultant Refugee Health Health Systems Coordinator (MSW) Refugee Health Epidemiologist Interns (x2)

5 International Health Core Functions Health Promotion: Provide support and resources to build our partners capacity to educate refugee, immigrant, and LEP communities. LEP Communications: Reach LEP persons with essential information in their language through trusted, community-based media sources. Build the capacity of MDH and partners to communicate effectively with diverse communities. Emerging Health Issues: Engage diverse stakeholders in responding to urgent concerns and developing community-driven, culturally relevant interventions. Consultation and Training: Lead colleagues and partners in enhancing the cultural relevance of their work and advancing health equity.

6 Refugee Health Core Functions To promote and enhance the health and well-being of refugees. We are committed to: Ensuring timely health assessment, treatment and referral for all new refugee arrivals to the state Educating health care professionals on best practices in refugee health Offering technical assistance, education and resources to local, state and community partners Providing leadership and guidance to refugee health professionals in other states; and promoting public health practices and policies that further our mission.

7 Refugee Health Screening in MN Exam w/in the first 90 days of arrival Public health clinics and private providers Goal:...to control communicable disease among, and resulting from, the arrival of new refugees through: health assessment treatment referral

8 Refugee Arrivals 2014* Kailey Urban *Data are preliminary

9 Kittson Marshall Roseau Lake of the Woods Koochiching 2014 Primary Refugee Arrival To Minnesota (N=2,465) Beltrami St. Louis Polk Pennington Cook Red Lake Clear Water Itasca Lake Norman Mahnomen Hubbard Cass Clay Becker Aitkin Wilkin Otter Tail Grant Douglas Wadena Todd Morrison Crow Wing Mille Lacs Kanabec Carlton Pine Number of Refugees Arrival By Initial County Of Resettlement 0 Traverse Big Stone Lac Qui Parle Yellow Medicine Lincoln Stevens Swift Lyon Pope Chippewa Renville Redwood Stearns Kandiyohi Brown Meeker Sibley McLeod Nicollet Benton Wright Sherburne Carver Le Sueur Anoka 71 Washing- Hennepin Ram- ton sey Scott Isanti Rice Dakota Chisago Goodhue Wabasha ,500 Pipestone Murray Cottonwood Watonwan Blue Earth Waseca Steele Dodge Olmsted Winona Rock Nobles Jackson Martin Faribault Freeborn Mower Fillmore Houston

10 Primary Refugee Arrivals, Minnesota 2014 Bhutan, 77 (3%) Ethiopia, 59 (2%) All Others**, 172 (7%) Iraq, 191 (8%) N=2,465* Burma, 838 (34%) Somalia, 1128 (46%) *Includes 2,409 primary refugees, 46 asylees, 7 victims of trafficking, and 3 parolees ** Other includes Afghanistan, Belarus, Cambodia, Cameroon, Cuba, DR Congo, Ecuador, El Salvador, Eritrea, the Gambia, Honduras, Iran, Kenya, Liberia, Moldova, Nepal, Russia, Rwanda, Sierra Leone, Sri Lanka, Sudan, Tanzania, Ukraine, and West Bank Data are preliminary Refugee Health Program, Minnesota Department of Health

11 Secondary Refugees Who is a secondary refugee? Secondary refugees are individuals who initially settle in a state other than Minnesota but soon migrate to live in Minnesota. This migration can occur within days, weeks, months or a year of a refugee s arrival to the U.S. Who notifies MDH of the arrival of a secondary refugee? MDH is most often notified of a secondary refugee s arrival into Minnesota from Local Public Health or a clinic. However, in some instances, the primary state may notify MDH that the refugee has moved to Minnesota.

12 Secondary Refugee Arrival Notifications to Minnesota, 2014 Iraq, 25 (3%) Burma, 13 (2%) All Others*, 6 (1%) N=800 Somalia, 756 (94%) Other includes Bhutan, China, and Ethiopia

13 Kittson Roseau Lake of the Woods 2014 Secondary Refugee Arrival Notifications To Minnesota (N=800) Marshall Koochiching Beltrami St. Louis Polk Pennington Cook Red Lake Clear Water Itasca Lake Norman Mahnomen Hubbard Cass Clay Becker Aitkin Wilkin Otter Tail Grant Douglas Wadena Todd Morrison Crow Wing Mille Lacs Kanabec Carlton Pine Number of Refugees Arrival By Initial County Of Resettlement 0 Traverse Big Stone Lac Qui Parle Yellow Medicine Lincoln Stevens Swift Lyon Pope Chippewa Renville Redwood Stearns Kandiyohi Brown Meeker Sibley McLeod Nicollet Benton Wright Sherburne Carver Le Sueur Anoka 71 Washing- Hennepin Ram- ton sey Scott Isanti Rice Dakota Chisago Goodhue Wabasha >301 Pipestone Murray Cottonwood Watonwan Blue Earth Waseca Steele Dodge Olmsted Winona Rock Nobles Jackson Martin Faribault Freeborn Mower Fillmore Houston

14 Making Overseas Vaccines Available in MIIC for New Refugees Goal: MDH will create records for newly arrived primary refugees in the Minnesota Immunization Information Connection (MIIC) and upload documented overseas vaccinations shortly after a refugee s U.S. arrival. Paper records carried by the refugees themselves often do not contain the most up-to-date vaccines The MIIC ID number will be recorded on the overseas paperwork and/or pink form and mailed out to LPH Schools and clinics can search for new refugees using available demographic information

15 Nurse Consultation Ellen Frerich

16 Nurse Role Partnership and Collaboration Resettlement agencies, local public health, clinics Big picture Review county reports and real time data; brainstorm around capacity Specifics Assist with planning for high health needs Screening tools available at our website Provider guide and pocket guide LPH/VOLAG Screening Manual: just updated!

17 Health Systems Coordination Marge Higgins

18 Complex Medical Cases LPH/VOLAG Objectives ( ): Expedite MA Expedite Screening Expedite Pri Care Urgent Referral to Specialist/Surgery Urgent Care / ER Good Work Everyone!!! Change Title from Medical Social Worker to Health Systems Coordinator Complex Case Data Cardiology/HTN Pregnancy Mental Health Blind/Vision Diabetes Asthma Phys. Disability Dev. Delay Seizure/Neuro Infectious Dis TOTAL Conditions TOTAL Cases

19 Community Outreach and Coordination Ann Linde Danushka Wanduragala

20 Refugee Health Orientation Workgroup Partnership and Collaboration Resettlement agencies, local public health, clinics, community organizations Key Health Messages US health system, preventive care, mental health resources Health Orientation Toolkit Explore and share existing resources; develop new resources for refugees and service providers

21 Questions?

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